On Oct. 15, the Centers for Medicare & Medicaid Services announced that clinicians who participated in the Merit-based Incentive Payment System (MIPS) in 2024 may now view their performance feedback, which includes the final score and payment adjustment factors.
The final score determines the payment adjustment that will be applied in 2026. A positive, negative or neutral payment adjustment will be applied to the Medicare-paid amount for covered professional services furnished in 2026. Additional information about MIPS payment adjustments is available here.
If an entity believes that there may be a discrepancy in the calculation of its final score, it may request that CMS review the calculations through a process called targeted review. Requests must be submitted by 8 p.m. ET on Nov. 14.
Examples of situations that may warrant a targeted review include:
- Data submitted under the wrong taxpayer identification number (TIN) or national provider identifier (NPI)
- Eligibility or special status issues (e.g., you have qualifying APM participant status and should not receive a payment adjustment)
- Performance categories not automatically reweighted, even though you qualify for reweighting due to extreme and uncontrollable circumstances
This list is not all-inclusive; other reasons may qualify for a targeted review.
To request a targeted review:
- Sign in using your HCQIS Access Roles and Profile (HARP) system credentials. These are the same credentials used to submit your 2024 MIPS data.
- Select “Targeted Review” from the left-hand navigation.
For questions about targeted reviews, contact the Quality Payment Program at 866-288-8292 or QPP@cms.hhs.gov.
Members with questions about the MIPS payment adjustment or targeted review process may email quality@aasm.org.
